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Partnering with patients to improve care: Essential skills and strategies

The 2015 conference of the MUHC-ISAI, chaired by Ms. Patricia O’Connor, Senior Advisor, Patient Engagement, MUHC, and special guest co-chair, Professor Angela Coulter, University of Oxford marked a second opportunity to focus on patient engagement. In 2014, we provided a broad look at why patient engagement has become a priority. In 2015, we narrowed the focus to look specifically at partnering with patients to design care processes that better meet patient needs. Presenters discussed emerging best practices and strategies to include patients as partners in healthcare improvement.

The UK is likely the most advanced country in creating structures and implementing policies to support patient partnership throughout the healthcare system. To open the conference, Angela Coulter offered an account of how patient engagement has evolved in the past few decades, and where it will take us in future.The evolution of patient engagement in care and service designProfessor Angela Coulter, University of Oxford VIEW SLIDES

SESSION 1 — PATIENT ENGAGEMENT LEADERSHIPThe first session explored what it takes to lead patient engagement, and this from three different perspectives. Carolyn Canfield has adopted “citizen-patient” to describe her role and has made a full time commitment to working internationally to transform healthcare culture. Leslee Thompson related her experience as a hospital director in integrating patients as real partners at Kingston General Hospital — a centre that has taken on almost mythic status in the patient engagement world. Dr. Tom Hutchinson shared lessons from palliative care at the McGill University Health Centre (MUHC) and the Cleveland Clinic program about the benefits of whole person care for patients and physicians.

SESSION 2: PATIENT PARTNERSHIP: RECRUITMENT, TRAINING, GOVERNANCE AND EVALUATIONThe presentations in Session 2 described how different health centres are integrating patient partners into their operations.PART 1. The Université de Montréal’s Office of Collaboration and Patient PartnershipThe Office of Collaboration and Patient Partnership at the Université de Montréal is leading the way in training and deploying patient advisors to undertake improvement work in a variety of settings. The conference heard from Sylvie Martel, who worked with the Office to integrate patient partners into quality improvement teams; Dr. Paule Lebel, co-director of the Office, on work underway to increase and strengthen their resources; and Marie-Pascale Pomey about progress in evaluating the impact of patient engagement on care and service design.

PART 2. Integrating patient engagement into organizational structures at the MUHCAt the McGill University Health Centre (MUHC), efforts are underway to integrate patient partnership into organizational structures. Karine Vigneault discussed the opportunities for patient partnership and measures that facilitate the recruitment and coaching of patient advisors. Emmanuelle Simony, who co-directs the project and also works on the MUHC’s users’ committee, described winning conditions for patients involved in these initiatives. Finally, Alain Biron looked at performance and patient experience measures that inform these improvement projects.

SESSION 3: HOW DOES THE PATIENT EXPERIENCE DRIVE IMPROVEMENT?Patient experience provides an important measure to guide improvement work. Much as institutions are adopting these measures and surveying patients, there is still much to learn about how to collect, package and use that information. The conference heard from Gary Teare about efforts in Saskatchewan to combine patient experience measures and Lean quality improvement methods in healthcare settings across the province. The challenge of collecting and using patient experience was pursued in Alain Biron’s presentation of an information management system being piloted at the MUHC to provide timely patient feedback, and by Tom Edgar’s description of ethnographic research undertaken at Roche to better understand the oncology patient journey.Creating feedback loops to monitor progressMr. Gary Teare, Chief Executive officer, Measurement and Analysis, Health Quality Council, Saskatchewan VIEW SLIDES

SESSION 4: BUILDING CAPACITY TO LEAD QUALITY IMPROVEMENT WITH PATIENT PARTNERS TheThe Canadian Foundation for Healthcare Improvement (CFHI) has led a two-year patient engagement collaborative to support healthcare centres across Canada in their efforts to partner with patients on improvements. In Session 4, the conference heard several of these projects presented by the healthcare professionals and patients involved.

SESSION 5: ENGAGING PATIENTS TO IMPROVE THE CLINICAL ENCOUNTERSession 5 turned to ways of using information around patient experience within clinical encounters to improve effectiveness and quality of care. Dr. Zeev Rosberger described an initiative to incorporate patient reported outcomes into cancer care. Dr. Alan Forster looked at ways to measure and improve the performance of healthcare professionals.

SESSION 6: PATIENT ENGAGEMENT IN PATIENT SAFETYSafety is an area where patients can play a much more significant role but need education and encouragement to question and challenge actions of healthcare professionals that may put them at risk. In Session 6, Andrea Bishop described a health behaviours approach to thinking about patient engagement in patient safety, and Dr. Sasha Dubrovsky and Aaron Fima described how a project at the MUHC’s Montreal Children’s Hospital is encouraging all patients and staff to talk more openly about potential safety concerns. Finally, one of the teams involved in the CFHI Collaborative presented their efforts to include patients in improving safety by involving them in shift-change transfers.

CLOSING PANEL: A BLUEPRINT FOR THE FUTUREThe conference ended by calling on a panel of leaders, all working to increase patient engagement in health system design and health care, to sketch out possible next steps. Two of Montreal’s most active patient partners, Mr. Mario Di Carlo, Co-chair, Central Users’ Committee, MUHC, and Mr. Vincent Dumez, Co-director, Office of Collaboration and Patient Partnership, Faculty of Medicine, Université de Montréal, chaired the session.Participants:Dr. Francine Girard, Deputy-Chair, Health Canada Advisory Panel on Healthcare InnovationMs. Maureen O’Neil, President, Canadian Foundation for Healthcare ImprovementMs. France Laverdière, Expert advisor, Department of Ethics and Quality, Quebec Ministry of Health and Social ServicesDr. Angela Coulter, Senior Research Scientist, Nuffield Department of Population Health, University of Oxford